Improvement of Overall Survival using TKIs as Salvage Therapy in Advanced Thyroid Carcinoma: Real-Life Data on a Single Center Experience

<i>Background:</i> Tyrosine kinase inhibitors (TKIs) have improved progression-free survival in patients with advanced thyroid cancer. So far, few studies have investigated the efficacy of TKIs in a second-line setting. The purpose of our study was to explore the salvage therapy efficacy...

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Main Authors: Lucia Brilli, Cristina Dalmiglio, Tania Pilli, Filomena Barbato, Fabio Maino, Marco Capezzone, Alessandra Cartocci, Maria Grazia Castagna
Format: Article
Language:English
Published: MDPI AG 2021-01-01
Series:Journal of Clinical Medicine
Subjects:
Online Access:https://www.mdpi.com/2077-0383/10/3/384
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spelling doaj-55043ac9a4674c9fb678e9faef4373a72021-01-21T00:03:59ZengMDPI AGJournal of Clinical Medicine2077-03832021-01-011038438410.3390/jcm10030384Improvement of Overall Survival using TKIs as Salvage Therapy in Advanced Thyroid Carcinoma: Real-Life Data on a Single Center ExperienceLucia Brilli0Cristina Dalmiglio1Tania Pilli2Filomena Barbato3Fabio Maino4Marco Capezzone5Alessandra Cartocci6Maria Grazia Castagna7Department of Medical, Surgical and Neurological Sciences, University Hospital of Siena, 53100 Siena, ItalyDepartment of Medical, Surgical and Neurological Sciences, University Hospital of Siena, 53100 Siena, ItalyDepartment of Medical, Surgical and Neurological Sciences, University Hospital of Siena, 53100 Siena, ItalyDepartment of Medical, Surgical and Neurological Sciences, University Hospital of Siena, 53100 Siena, ItalyDepartment of Medical, Surgical and Neurological Sciences, University Hospital of Siena, 53100 Siena, ItalyDepartment of Medical, Surgical and Neurological Sciences, University Hospital of Siena, 53100 Siena, ItalyDepartment of Medical Biotechnologies, University of Siena, 53100 Siena, ItalyDepartment of Medical, Surgical and Neurological Sciences, University Hospital of Siena, 53100 Siena, Italy<i>Background:</i> Tyrosine kinase inhibitors (TKIs) have improved progression-free survival in patients with advanced thyroid cancer. So far, few studies have investigated the efficacy of TKIs in a second-line setting. The purpose of our study was to explore the salvage therapy efficacy in patients with advanced thyroid cancer. <i>Methods:</i> We retrospectively evaluated 63 patients with progressive advanced thyroid carcinoma treated with TKIs divided into a Study group (23 patients) treated with salvage therapy, and a Control group (40 patients) treated with only one TKI. <i>Results:</i> Similar clinical benefits (stable disease + partial response) and progression free survival between the first and the second line TKI were observed in the Study group (<i>p</i> > 0.99 and <i>p</i> = 0.5, respectively). Median overall survival (OS) was 67.7 months in the Study group and 22.6 months in the Control group (HR 2.46; 95% CI 1.34–4.52, <i>p</i> = 0.004). After stratifying the whole population by age (<65 and ≥65 years), OS was significantly different (<i>p</i> < 0.001) with the best survival curve in younger patients, treated with salvage therapy and the worst in older subjects, treated with only one TKI. <i>Conclusions:</i> Salvage therapy showed a significant improvement of OS in patients with advanced thyroid cancer who experienced disease progression during prior TKI therapies.https://www.mdpi.com/2077-0383/10/3/384tyrosine kinase inhibitorsthyroid cancersalvage therapy
collection DOAJ
language English
format Article
sources DOAJ
author Lucia Brilli
Cristina Dalmiglio
Tania Pilli
Filomena Barbato
Fabio Maino
Marco Capezzone
Alessandra Cartocci
Maria Grazia Castagna
spellingShingle Lucia Brilli
Cristina Dalmiglio
Tania Pilli
Filomena Barbato
Fabio Maino
Marco Capezzone
Alessandra Cartocci
Maria Grazia Castagna
Improvement of Overall Survival using TKIs as Salvage Therapy in Advanced Thyroid Carcinoma: Real-Life Data on a Single Center Experience
Journal of Clinical Medicine
tyrosine kinase inhibitors
thyroid cancer
salvage therapy
author_facet Lucia Brilli
Cristina Dalmiglio
Tania Pilli
Filomena Barbato
Fabio Maino
Marco Capezzone
Alessandra Cartocci
Maria Grazia Castagna
author_sort Lucia Brilli
title Improvement of Overall Survival using TKIs as Salvage Therapy in Advanced Thyroid Carcinoma: Real-Life Data on a Single Center Experience
title_short Improvement of Overall Survival using TKIs as Salvage Therapy in Advanced Thyroid Carcinoma: Real-Life Data on a Single Center Experience
title_full Improvement of Overall Survival using TKIs as Salvage Therapy in Advanced Thyroid Carcinoma: Real-Life Data on a Single Center Experience
title_fullStr Improvement of Overall Survival using TKIs as Salvage Therapy in Advanced Thyroid Carcinoma: Real-Life Data on a Single Center Experience
title_full_unstemmed Improvement of Overall Survival using TKIs as Salvage Therapy in Advanced Thyroid Carcinoma: Real-Life Data on a Single Center Experience
title_sort improvement of overall survival using tkis as salvage therapy in advanced thyroid carcinoma: real-life data on a single center experience
publisher MDPI AG
series Journal of Clinical Medicine
issn 2077-0383
publishDate 2021-01-01
description <i>Background:</i> Tyrosine kinase inhibitors (TKIs) have improved progression-free survival in patients with advanced thyroid cancer. So far, few studies have investigated the efficacy of TKIs in a second-line setting. The purpose of our study was to explore the salvage therapy efficacy in patients with advanced thyroid cancer. <i>Methods:</i> We retrospectively evaluated 63 patients with progressive advanced thyroid carcinoma treated with TKIs divided into a Study group (23 patients) treated with salvage therapy, and a Control group (40 patients) treated with only one TKI. <i>Results:</i> Similar clinical benefits (stable disease + partial response) and progression free survival between the first and the second line TKI were observed in the Study group (<i>p</i> > 0.99 and <i>p</i> = 0.5, respectively). Median overall survival (OS) was 67.7 months in the Study group and 22.6 months in the Control group (HR 2.46; 95% CI 1.34–4.52, <i>p</i> = 0.004). After stratifying the whole population by age (<65 and ≥65 years), OS was significantly different (<i>p</i> < 0.001) with the best survival curve in younger patients, treated with salvage therapy and the worst in older subjects, treated with only one TKI. <i>Conclusions:</i> Salvage therapy showed a significant improvement of OS in patients with advanced thyroid cancer who experienced disease progression during prior TKI therapies.
topic tyrosine kinase inhibitors
thyroid cancer
salvage therapy
url https://www.mdpi.com/2077-0383/10/3/384
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